Do you want to be paid for caring for your family member with a disability?

Frequently asked question

Yes! It is possible for a family member to be paid for caring for another family member. It is likewise possible for parents of minor children to be paid and for spouses to be paid. While these situations are possible, they are not guaranteed. There is great variation from state to state and there is even variation between programs within the same state. The federal government allows the states a lot of flexibility in determining who can provide services and what their qualifications are. Some states think it makes perfect sense for family members to provide care for other family members and are very supportive of this role. Other states feel that family ought to help family anyway and so do not see a reason, or need, to pay. Many states feel that parents of minor children and spouses are already legally obligated to provide care and nurture for their children or spouses. This being the case, why should they pay?

A final common and important factor is the states' nursing and licensure laws. Most states' nursing laws provide exemptions in the law for parents and spouses to provide care for their family members and minor children as long as it is gratuitous. As soon as payment comes into the picture, however, things change. The problem is that many of the supports that people need constitute nursing under state law and require a license or for the caregiver to, at least, be supervised by a health professional with a license. Even simple things like opening a pill bottle or changing a band-aid can require that a person have a license.

Because there is so much variation, I almost always recommend contacting a states' Medicaid officials to explain the possibilities. If permissible in a state, you need to be aware that there are steps to this process. For example, before being paid, the family member must first qualify for a program that will provide the funding or the payment (if the family member is not already eligible for services). Then, the person eligible to receive the service or assistance must select or hire the family member so they can be enrolled or processed by an agency that will actually be paying the wages, taxes, benefits, etc.

Our website can assist with locating contact information that will be useful for beginning the process of asking the necessary questions and finding out the answers mentioned above. The PAS Center website has contact information for every state Medicaid program in the USA and Territories. Just go to Agencies Related to PAS. Next, click on your State on the USA map. Next, click on "Medicaid Agency". You will find the contact information you need to get started and usually a website that can be very helpful once you start poking around.

Regard,
Mike Oxford

Other related questions … 



Live in son being an independent provider for his father … 

Dear Mike,

Can a live in son be an independent provider for his father?

Thank you,

Son as Provider

Dear Son as Provider,

Thanks for writing. There are a couple of things you should know about whether a live-in son can be a paid provider for a father … 

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Can I get paid to look after my son who has a disability … 

Dear Mike,

I am a registered nurse in Ohio. I currently have a disabled son that I care for on my own. He has autism and also a heart condition. I have been missing much work lately due to his conditions. I was told I may be able to be paid to care for him full time.......a single mothers dream.....since his father stepped out of the picture things have been very difficult for us. I was recently pulled into human resources and told I have a hard decision to make...... do I want to be a mother to my disabled child or continue to work at the hospital? I told them that my child will always come first and it is sad to me that they would expect anything different. Needless to say I still work there while my son pays in the long run.......please help........can I get paid to care for him? Where do I start?

Ohio nurse.

Dear Ohio nurse,
You wrote wanting to know if you can be paid to assist your son. This type of question is the most frequent of all of those I have received … 

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Can a parent be paid to stay home and care for their child with a disability? … 

Dear Mike,

I have a question regarding consumer-directed attendant care services for children in West Virginia. I had heard from a parent that I work with in Virginia that parents in West Virginia can be the paid caregiver of a child with a disability receiving waiver services. This is the opposite of Virginia and I was just wondering if there was any truth to that. Can a parent/primary caregiver in West Virginia be paid to stay home and care for their child with a disability if that child is receiving waiver services?

Thank you,

A caring parent

Dear Caring Parent,

The basic rule of Medicaid is that parents of minor children CANNOT be paid caregivers unless they are so rural and/or the services are so technical and specialized that no other provider is available. This is almost a case-by-case situation … 

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Can I get paid for helping my mother? … 

Dear Mike,

My mother who lives in Illinois, needs help with all sorts of living needs. I currently live in California but am moving to Illinois to help her. Can I get paid for this help as a personal attendant?

Thank you,

Going to Illinois

Dear Going to Illinois,

Thank you for writing. You say that your mother needs help with all sorts of things and that you are moving from California to Illinois to help her … 

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Can I get paid to stay at home and provide care to my sister? … 

Dear Mike,

I have a sister that has mental handicaps. She is in the adult program of CPS in Arizona. I am wondering if I can get paid to stay home with her and provide care. I would do it without being paid but somebody's got to bring home the bacon. My sister would require full time supervision. Any info on this would be appreciated

Thanks,

Arizona Sister

Dear Arizona Sister,

You write that your sister has mental disabilities and is receiving services "in the adult program of CPS" in Arizona. You wonder if you can be paid to stay home with her and provide her 'care'.

All things being equal, you should be able to be a paid provider of your sister's services … 

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I want to be able to nurse my daughter … 

Dear Mike,

I have a 28 year old daughter with epilepsy and learning disablities.

She has had a Licensed Practical Nurse (LPN) for 8 years that has been caring for her. I just found out that I can care for her instead of the nurse who is not the best choice for our daughter. I went through the requirements asked of me and the Nursing brokerage had me signed on to start. I have been denied from the Ohio home care program. My daughter has been nearly seizure free and I have been the person to train the nurses anyway. We want to take her care level down from nurse-to-home health aide. The reason quoted on my denial papers read: Personal care aide services are not medically necessary, consumer needs can be met with Skilled Nursing Services.

The nurse we have now is overweight and has already had 2 nervous breakdowns and is heading towards the 3rd. I do not want to go through having a stranger back in my home. I want to care for her and do the things that since her recovery, have made her more aware and alert and able to do more active things rather than sitting in front of the TV after I leave for work.

Help. What should I do for this hearing?

Thank you,

Caring parent

Dear Caring Parent,

I am sorry I cannot always respond, nor guarantee a response, quickly enough to help in certain situations such as your hearing. Have you already had the hearing? I will share some ideas, that if not useful for your hearing, may be helpful in understanding the situation … 

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Can I get paid to take care of my father in his home? … 

Hi Mike

My Father has a home in Arizona, lives in a Montana nursing facility but wants to go back home to Arizona. I live in Oregon and am willing to move to Arizona to take care of him so he can be where he wants to live out his life.

He has had a stoke and I would like to be his care giver. Can I get paid to take care of him in his home?

Going to Arizona

Dear Going to Arizona,

Thanks for submitting a question to "Ask Mike". You write that your father would like to move from a nursing facility in Montana to his own home in Arizona City, AZ. You currently live in Oregon and would like to move to Arizona to be his care giver and want to know if you can be paid to do so?

The short answer is likely "yes" … 

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Being paid by medicaid to care for my child in Arizona … 

Hello Mike

I'm a Certified Nursing Assistant (CNA) for my child in Denver, Colorado. I get paid by medicaid. I was wondering if there is a program in Arizona that does the same.

Thanks

Colorado to Arizona

Dear Colorado to Arizona,

Thanks for writing. Your question is about whether you can be paid to do in Arizona what you do now in Denver Colorado, which is to be a paid CNA for your child.

You should contact the … 

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Want to become a personal assistant for my mother-in-law … 

Hello Mike

I'm interested in becoming a personal assistant for my mother-in-law who has a mental disability. She receives Social Security for this disability and needs help with everyday living. I help her by cooking, cleaning, giving her medication, taking her to appointments, etc. I live in Chicago and have contacted The Department of Health and Human Services, The Social Security Administration, Medicaid, and a number of other agencies who can't seem to help me and keep giving me the run around. Do you have any advice or suggestions on what I steps I should take to become her paid personal assistant?

Signed

Wants to be PA

Dear Wants to be PA,

Thanks for writing. You want to know how to become a paid personal assistant for your mother-in-law who has a mental disability. You currently provide assistance with things like cooking, cleaning and medication administration, but would like to be paid … 

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Being payed to care for disabled son … 

Dear Mike,

I have been taking care of my adult son with mental and physical impairments and he is on SSD. I have been providing day care in my home for three years and I now need to stop this and take care of my son. How can I find out how to get paid to take care of him now. We live in Ohio.

Thank you

Cares for Son in Ohio

Dear Cares for Son in Ohio,

Federal rules do not prohibit your being paid to provide direct services and supports to your son … 

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Nurse wanting to paid through clients insurance … 

Dear Mike,
I am a Certified Nursing Assistant (CNA) in the state of Pennsylvania. I would like to know how to be able to have my clients pay me for my work and care through their insurance. It would be a help if this were possible.

Dear Hoping,

It appears that there are at least two barriers to your being directly paid … 

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Wanting to be paid to care for disabled sister … 

Dear Mike,

I have a disabled sister who I care for at home. I want to know how I would go about getting paid for this. She's already receiving SSI and Social Security benefits. I want to quit my job and care for her permanently. Is there any financial programs that can help me out. Thank you very much.

Signed,

Wants to help sister

Dear Wants,

Thanks for writing. Your question is a common one. Family members getting paid to provide services and supports to family members has become the most frequent "Ask Mike" issue; your question asks how you can be paid to care for your sister … 

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Would a felony conviction prevent me from being my daughter's carer? … 

Dear Mike

I would like to find out if my felony 8 years ago will prevent me becoming my daughter's provider?

Yours,

Wondering about Felony

Dear Wondering about Felony,

Thank you for writing. You wanted to know if a felony conviction 8 years ago would prevent you from being your daughter's direct support staff … 

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Can I get paid to be a caregiver for my disabled child? … 

Dear Mike,

I live in Kansas state and I want to know if a mom can get paid to be a caregiver for her disabled child (home health care service)?

Yours Curious in Kansas

Dear Curious in Kansas,

Thanks for writing. You ask whether the mom in Kansas could be paid to be a caregiver (of home health services) for her disabled child. The short answer is "Maybe" … 

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Wants to get paid to care for her Mom … 

Hi Mike,

my Mom is in need of assistance I've been helping her with everything - I take her to doctor appointments and hydrobarics everyday appointments three times a week. Is there a way Ii could get paid?

Thanks,
She Wants to Get Paid

Dear She Wants to Get Paid,

The short answer to your question is: "maybe". It depends on the State in which your mom resides and whether … 

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Can I get paid to look after my son who has speech and language problems … 

Dear Mike,
I have a 4 year old son that has speech and language problems. Someone told me I can get paid for taking care of him. I am not working right now and I do really need that money for his own needs. I am in Los Angeles CA.

Thanks,
LA Mom

Dear LA Mom,
I sympathize with your predicament, but I am not aware of any program or funding stream that would pay you to take care of your son just because he has speech and language impairments … 

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Moving my dad out of a nursing home … 

Dear Mike,

My Dad is in a nursing home near me, since my Mom did not want to take care of him. She has not seen him since he had his stroke (7 years ago) and I am the only person in the family who has taken care of him. Her and I have not spoken for 7 years, and I want nothing to do with her.

We have decided to have him move in with us now. He is currently on Medi-cal and Medicare and fully covered in the nursing home, and we have to deal with my Mom once a year when she files the financial paperwork and she keeps the social security check of his to help pay the mortgage on the house they own.

They both want a divorce but are too poor to do anything.

Anyway I have Power of Attorney , and need to move his case to my county, since she lives in a different county, but the social worker said she cannot do that while he is still in the nursing home. This is a problem since I have to set up IHSS and check on his benefits and all kinds of things before I move him in, I want to make sure we can afford it and he has enough benefits to make it. He will finally get his SS back again which is all he has now in the world.

Is there anything I can do to get this case transferred before he leaves the nursing home?

Yours,

Taking Care of Dad

Dear Taking Care of Dad

Unfortunately, I am not familiar with the entire minutia of MediCal and the various California rules and regs; not to mention the impact  … 

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Is there any chance that I can get paid to stay home and care for my son … 

Dear Mike,

I am a single mother with a disabled son (application for SSI is pending now). He is nine years old and diagnosed with severe ADHD, impulsive disorder and has an additional learning disability of Dyslexia and Dysgraphia on top of his ADHD. He has seen numerous psychologists since the age of three. He has been kicked out of several day cares and pre-k systems since the age of three and still currently the school calls on average about twice a week to pick him up due to severe emotional outburst and severe anger issues leading to violence (usually inflicted upon himself). I have had to completely stop working due to his problems and this is severely financially devastating to us. I cannot even find an after school care program that will keep him. To make matters worse, his entire family (both fathers and mothers side) cannot and will not help me with him! I live in Louisiana and in desperate need of some financial assistance! His tutoring for his disabilities is on average $800 a month and insurance will not pay anything for it because of the nature of the particular learning disability (it is considered a hidden disability). His father refuses to help pay as well! Is there any chance that I can get paid to stay home and care for him?

Thank you in advance for any advice

Son in School

Dear Son in School,

Before I respond to the issue of being paid to provide services and supports, you need to be aware of your son's right to a free and appropriate public education … 

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Can I get paid to look after my Dad … 

Mike,

I moved to Oregon 4 months ago from California to take care of my Dad. Can I get paid for taking care of him?

Thanks,
Moved to Oregon

Dear Moved to Oregon,
Thanks for writing to me about wanting to be paid for assisting your Dad in Oregon. Several people from different states have asked this question in one form or another … 

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Getting paid for taking care of my mother-in-law … 

Dear Mike,

I am writing to find out of there is a payment program available in Wisconsin to help off set the costs of caring for my mother-in-law. She had a stroke just over a year ago. She requires 24 hour care in her home. My husband and I have moved our family in with her to help her pay her bills and mortgage. Since her insurance does not cover in home nursing care and she cannot afford to pay anybody for caring for her, I have had to leave my full time job to care for her. We are also pretty sure between her social security benefits and her widowers pension that she makes too much money per month to qualify for medicaid. Is there anything we can do to get paid for taking care of her? I am spending 50+ hours per week just taking care of her and my husband does the rest. Please let us know if you have any suggestions.

Thank you.

Wondering in Wisconsin

Dear Wondering in Wisconsin,

You describe a situation that is all too common … 

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Compensation for caring for a daughter with a chronic illness … 

Dear Mike,

I'm only 24 years old with a ... dependent child. It has been a struggle both mentally and financially. I worked for a period of 8 months but my supervisor couldn't seem to notice my dedication to work. I only missed 1 day out of the 8 month period. She had to discuss my daughters medical needs with other employees with out my consent. I had no choice but to quit I'm hoping you could answer this - can I be compensated due to my daughters chronic illness or is there anything that I can do at home. Please let me know. It feels like I'm never going to get past this.

Thank you,

Mom from New Mexico.

Dear Mom from New Mexico,

Thanks for writing. You have a daughter with a multiple developmental disabilities. You have had to stop working in order to be able to care for your daughter and want to know if there is any compensation available for this situation … 

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Can I get income for caring for my son … 

Dear Mike,

I have a 22 year old son with autism I have been caring for him since birth. I was talking to someone about my son's disabilty and they told me that I can get income for caring for him and to look under medicaid waiver. Could you please give me information on this please.

Thank You,

Parent Curious About Waiver

Dear Parent Curious About Waiver

The first thing you need to do is to determine whether your son is eligible for Medicaid Waiver services. If your son is an adult, this is quite likely … 

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